Heart failure is today a major health problem that affects more than five millions people in US and accounts for about 500,000 new cases each year and its prevalence is steadily increasing. It consists in a condition in which a problem with the structure or function of the heart impairs its ability to supply sufficient blood flow to meet the body's needs.
This pathology is caused by different factors and results for several complex mechanisms. For the clinical management of this serious disorder, the finding of new biomarkers and therapeutic targets appear to have a growing importance. Particularly, for an easier monitoring, research now focuses on serum biomarkers.
An increasing number of enzymes, hormones, biological substances and other markers of cardiac system are used as biomarker of cardiac disorders such as heart failure. Currently, among biomarkers used for the management of heart failure after myocardial infarction appear serum troponin T (Newby L K et al, 1998; Latini R et al, 2007) and troponin I, B-type natriuretic peptide (BNP) and C-reactive protein (CRP). These biomarkers assess different pathways that have been implicated in the pathogenesis of heart failure: BNP is elevated in response to left ventricular overload; CRP is a marker of inflammation; and elevations in troponin indicate myocyte injury.
However, there is still a need of new biomarkers for the management of heart failure, for an earlier detection or appreciation of risk for such disorder and easier tests.
Left ventricular remodeling after myocardial infarction is observed in approximately 30% of patients despite modern therapeutic strategies. Initially, left ventricular remodeling can be considered as a protective mechanism maintaining cardiac pump function, but ultimately it leads to deterioration in global left ventricular function and to heart failure. Since myocardial infarction is a frequent event (120 000 cases/year in France), left ventricular remodeling is an important contributor to the current epidemic of heart failure. The discovery of circulating markers specific to remodeling would allow for the development of biological tests predicting a development to heart failure.